A large new clinical study adds to the
growing body of evidence supporting the use of the small fruits
of vitex, also known as chastetree (Vitex agnus-castus
L., Verbenaceae), in the treatment of premenstrual syndrome (PMS),
a variable complex of symptoms affecting up to 40 percent of fertile
women (Loch et al., 2000).

According to results of the open-label
German trial, 93 percent of study participants reported that their
PMS symptoms either decreased or disappeared altogether after
treatment with vitex over the course of three menstrual cycles.
According to the investigators, PMS has been associated with up
to 150 different symptoms, most of which fall into four classic
"symptom complexes" defined as depression, anxiety, craving, and
hyperhydration (DACH). Their study was designed to assess the
efficacy and tolerability of a new solid vitex preparation called
FemicurŪ, manufactured by Schaper & Brummer GmbH & Co., Salzgitter,
Germany. Each capsule contains 1.6-3.0 mg dried extract of vitex
berry in a ratio of 6.7-12.5:1, equivalent to 20 mg of dried berry.

The 1634 study participants received treatment
with one capsule twice daily of Femicur, and changes from baseline
were recorded on questionnaires completed by physicians based
on interviews conducted before treatment and again after three
menstrual cycles. The questionnaires were specifically designed
to determine the effect of vitex on psychological and physical
symptoms, the four classic DACH complexes, and single groups of
characteristic symptoms. Improvement was assessed according to
the standard Clinical Global Impression Scale, which allows patients
to rate symptomatic change on a scale of one to seven (very much
improved to very much worse).

At the end of the trial, statistically
significant decreases were observed in the frequency of all symptoms
and DACH complexes. Forty-two percent of patients reported that
they were no longer affected by PMS, 51 percent had a decrease
in symptoms, six percent reported no change, and one percent reported
an increase in the number of symptoms. Eighty-six percent of physicians
noted that vitex treatment had "a pronounced efficacy," and 81
percent of participants rated their status after treatment as
"very much or much better." With regard to tolerability, 94 percent
of the women rated the vitex preparation as good or very good,
and no serious side effects were reported. Minor side effects
reported by the remaining women included mild skin reactions and
gastrointestinal upset. In an interesting aside, the authors suggested
that vitex may have had a positive effect on fertility for some
women who had trouble becoming pregnant before the trial. They
noted, "Data from this trial support the occasionally described
restoration of fertility by Vitex treatment. No woman was pregnant
at the start of Vitex therapy, and 19 of the 23 women who conceived
while on Vitex treatment belonged to the group of 126 women (8%)
who had been to date unsuccessful at becoming pregnant."